Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Pediatric Surgery International
Erschienen in: Pediatric Surgery International 5/2012

01.05.2012 | Original Article

Pediatric surgical site infection in the developing world: a Kenyan experience

verfasst von: James H. Wood, Peter M. Nthumba, Edita Stepita-Poenaru, Dan Poenaru

Erschienen in: Pediatric Surgery International | Ausgabe 5/2012

Einloggen, um Zugang zu erhalten

Abstract

Background

The purpose of the current study was to determine the incidence of pediatric surgical site infections (SSIs) at an academic children’s hospital in rural sub-Saharan Africa and to identify potentially modifiable risk factors.

Methods

Prospectively collected data from 1,008 surgical admissions to BethanyKids Kijabe Hospital (Kijabe, Kenya) were analyzed retrospectively. Follow-up data were available in 940 subjects.

Results

SSIs occurred in 6.8% of included subjects (N = 64). Superficial (69%) and deep (29%) infections of the back (38%) and head (25%) were most common. When comparing children who developed SSI to those who did not, we found that wound contamination classification and duration of operation were the only variables with significant differences between groups.

Conclusions

Our rate of SSI among pediatric patients in sub-Saharan Africa is the lowest reported in the literature to date. More work is needed to identify modifiable risk factors for pediatric SSI in low- and middle-income countries.
Literatur
1.
Raval M, Dillon P, Bruny J et al (2011) American College of Surgeons National Surgical Quality Improvement Program Pediatric: a phase 1 report. J Am Coll Surg 212:1–11PubMedCrossRef
2.
Ameh EA, Mshelbwala PM, Nasir AA et al (2009) Surgical site infection in children: prospective analysis of the burden and risk factors in a sub-Saharan African setting. Surg Infect 10:105–109CrossRef
3.
Allegranzi B, Nejad S, Comberscure C et al (2011) Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet 377:228–241PubMedCrossRef
4.
Nthumba P, Stepita-Poenaru E, Poenaru D et al (2010) Cluster-randomized, crossover trial of the efficacy of plain soap and water versus alcohol-based rub for surgical hand preparation in a rural hospital in Kenya. Br J Surg 97:1621–1628PubMedCrossRef
5.
Horan T, Gaynes R, Martone W et al (1992) CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 13:606–608PubMedCrossRef
6.
Nichols RL (1998) Postoperative infections in the age of drug-resistant Gram-positive bacteria. Am J Med 104:11S–16SPubMedCrossRef
7.
Haley RW, Culver DH, White JW et al (1985) The nationwide nosocomial infection rate: a new need for vital statistics. Am J Epidemiol 121:159–167PubMed
8.
Hodges A, Agaba S (1997) Wound infection in a rural hospital: the benefit of a wound management protocol. Trop Doct 27:174–175PubMed
9.
Wariso B, Nwachukwu C (2003) A survey of common pathogens in wound in patients at the University of Port Harcourt Teaching Hospital. West Afr J Med 22:50–54PubMed
10.
Eriksen H, Chugulu S, Kondo S et al (2003) Surgical-site infections at Kilimanjaro Christian Medical Center. J Hosp Infect 55:14–20PubMedCrossRef
11.
Fehr J, Hatz C, Soka I et al (2006) Risk factors for surgical site infection in a Tanzanian district hospital: a challenge for the traditional National Nosocomial Infections Surveillance system index. Infect Control Hosp Epidemiol 27:1401–1404PubMedCrossRef
12.
Sharma LK, Sharma PK (1986) Postoperative wound infection in a pediatric surgical service. J Pediatr Surg 21:889–891PubMedCrossRef
13.
Duque-Estrada EO, Duarte MR et al (2003) Wound infection in pediatric surgery: a study of 575 patients in a university hospital. Pediatr Surg Int 19:436–438PubMedCrossRef
14.
Mwachaka P, Obonyo N, Mutiso B et al (2010) Ventriculoperitoneal shunt complications: a three-year retrospective study in a Kenyan national teaching referral hospital. Pediatr Neurosurg 46:1–5PubMedCrossRef
15.
Horwitz J, Chwals W, Doski J et al (1998) Pediatric wound infections: a prospective multicenter study. Ann Surg 227:553–558PubMedCrossRef
16.
Lawal O, Adejuyigbe O, Oluwole F (1990) The predictive value of bacterial contamination at operation in post-operative wound sepsis. Afr J Med Sci 19:173–179
17.
18.
Haynes A, Weiser T, Berry W et al (2009) A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med 360:491–499PubMedCrossRef
19.
20.
Mangram A, Horan T, Pearson M et al (1999) Guideline for the prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 20:247–278CrossRef
21.
Bratzler D, Houck P (2004) Antimicrobial prophylaxis for surgery: an advisory statement for the National Surgical Infection Prevention Project. Clin Infect Dis 38:1706–1715PubMedCrossRef
22.
Bratzler D, Houck P, Richards C et al (2005) Use of antimicrobial prophylaxis for major surgery: baseline results from the national surgical infection prevention project. Arch Surg 140:174–182PubMedCrossRef
23.
Classen D, Evans R, Pestotnik SL et al (1992) The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. N Engl J Med 326:281–286PubMedCrossRef
24.
Dellinger E, Gross P, Barrett TL et al (1994) Quality standard for antimicrobial prophylaxis in surgical procedures. The Infectious Diseases Society of America. Infect Control Hosp Epidemiol 15:182–188PubMedCrossRef
25.
Dellinger E (2007) Prophylactic antibiotics: administration and timing before operation are more important than administration after operation. Clin Infect Dis 44:928–930PubMedCrossRef
26.
Bucher B, Guth R, Elward A et al (2011) Risk factors and outcomes of surgical site infection in children. J Am Coll Surg (in press)
27.
Geubbels E, Grobbee D, Vandenbroucke-Grauls C et al (2006) Improved risk adjustment for comparison of surgical site infection rates. Infect Control Hosp Epidemiol 27:1330–1339PubMedCrossRef
28.
Leong G, Wilson J, Charlett A (2006) Duration of operation as a risk factor for surgical infection: comparison of English and US data. J Hosp Infect 63:255–262PubMedCrossRef
29.
Kurz A, Sessler DL, Lenhardt R et al (1996) Perioperative normothermia to reduce the incidence of surgical wound infection and shorten hospitalization. N Engl J Med 334:1209–1216PubMedCrossRef
30.
Garibaldi R, Skolnick D, Lerer T et al (1988) The impact of preoperative skin disinfection on preventing intraoperative wound contamination. Infect Control Hosp Epidemiol 9:109–113PubMedCrossRef
31.
Drapeau C, Pan A, Bellacosa C et al (2009) Surgical site infections in HIV-infected patients: results from an Italian prospective multicenter observational study. Infection 37:455–460PubMedCrossRef
Metadaten
Titel
Pediatric surgical site infection in the developing world: a Kenyan experience
verfasst von
James H. Wood
Peter M. Nthumba
Edita Stepita-Poenaru
Dan Poenaru
Publikationsdatum
01.05.2012
Verlag
Springer-Verlag
Erschienen in
Pediatric Surgery International / Ausgabe 5/2012
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-012-3058-x

Weitere Artikel der Ausgabe 5/2012

Pediatric Surgery International 5/2012 Zur Ausgabe

Original Article

Transanal endorectal pull-through for Hirschsprung’s disease using long cuff dissection and short V-shaped partially resected cuff anastomosis: early and late outcomes

Original Article

Inhibition of ACE activity contributes to the intestinal structural compensation in a massive intestinal resection rat model

Original Article

Re-operation for Hirschsprung’s disease: experience in 24 patients from China

Original Article

Therapeutic outcome and prognosis in young patients with papillary and follicular thyroid cancer

Original Article

Magnetic compression gastrostomy in the rat

Original Article

Management of lymphadenitis due to non-tuberculous mycobacterial infection in children

Neu im Fachgebiet Pädiatrie

Kinder mit anhaltender Sinusitis profitieren häufig von Antibiotika

30.04.2024 Rhinitis und Sinusitis Nachrichten

Persistieren Sinusitisbeschwerden bei Kindern länger als zehn Tage, ist eine Antibiotikatherapie häufig gut wirksam: Ein Therapieversagen ist damit zu über 40% seltener zu beobachten als unter Placebo.

Neuer Typ-1-Diabetes bei Kindern am Wochenende eher übersehen

23.04.2024 Typ-1-Diabetes Nachrichten

Wenn Kinder an Werktagen zum Arzt gehen, werden neu auftretender Typ-1-Diabetes und diabetische Ketoazidosen häufiger erkannt als bei Arztbesuchen an Wochenenden oder Feiertagen.

Neue Studienergebnisse zur Myopiekontrolle mit Atropin

22.04.2024 Fehlsichtigkeit Nachrichten

Augentropfen mit niedrig dosiertem Atropin können helfen, das Fortschreiten einer Kurzsichtigkeit bei Kindern zumindest zu verlangsamen, wie die Ergebnisse einer aktuellen Studie mit verschiedenen Dosierungen zeigen.

Spinale Muskelatrophie: Neugeborenen-Screening lohnt sich

18.04.2024 Spinale Muskelatrophien Nachrichten

Seit 2021 ist die Untersuchung auf spinale Muskelatrophie Teil des Neugeborenen-Screenings in Deutschland. Eine Studie liefert weitere Evidenz für den Nutzen der Maßnahme.

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise